I was pursuing some message boards the other day and someone dared to ask about withdrawal.
I say dared to ask because it seems like it was daring, at least from the strong berating they got in the many answers that followed.
“Withdrawal doesn’t work, that’s how people get pregnant!”
“Wow, what are they teaching kids these days? Withdrawal isn’t a method of birth control.”
“Pre-ejaculate has tons of sperm in it, that’s why withdrawal doesn’t work.”
And so on… You can basically see the same types of answers in this yahoo answers question.
At the same time, I was talking to the people in HER fertility in our awesome little facebook group of birth control methods and specifically the use of withdrawal (but, of course, this conversation was much more sane ;)).
You’ve probably heard a lot of the same, but how much of it is actually true and how much of it is just myths that have been propagated so that people who really shouldn’t be using withdrawal don’t? Let’s start with the basics and dig in!
What is withdrawal
Withdrawal… Pulling out, coitus interruptus. You probably know it by one of these names but don’t really know that much about it (or, you are like a hugely increasing amount of women/couples using the method either alone or in conjunction with other methods and feeling kind of ashamed about it).
Withdrawal is simple really, and I’m sure it’s been used as birth control for a loooong time. Basically, you just don’t let ejaculate get in or on the vagina or vulva. Extremely simple in theory, but in practice can get somewhat more complicated, which I’ll cover a bit more in a minute.
Unfortunately withdrawal gets a bad rap. It’s not the perfect method of birth control (nothing really is, they can only be more right or more wrong for you), but it has more merit than it’s typically given credit for. In fact, a lot of people don’t consider withdrawal birth control at all.
Why most people consider it nothing
Withdrawal really isn’t looked kindly upon in almost any sector of people. There are the people who are against birth control that obviously hate withdrawal, and then there are the people that love birth control but hate withdrawal, claiming it’s not effective enough or that most couples can not use it correctly.
All that adds up to really bad PR for withdrawal. Pretty much the ultimate bad PR is to not even be considered in the class of things you are, right?
But when a lot of us start learning about birth control methods it happens to be sex ed or the doctors office, neither of which would ever dare to mention withdrawal as a method (actually, I’d love to know if either of those things ever mentioned withdrawal other than “don’t do it” for you, so if you did hear about it please leave a comment!). Because we aren’t taught of withdrawal as a method we end up saying it isn’t a method at all.
I can’t tell you how many friends I have had tell me they don’t actually use birth control, only to find out they use withdrawal religiously.
But, you know a little better, right? You know withdrawal is a birth control method, but how risky is it, really?
Studies done on pre-ejaculate
Of course, one of the things you want to keep in mind when it comes to using withdrawal as birth control is that, even when you use it perfectly (more on that below), you still have the chance of getting pregnant from pre-ejaculate.
There have been a couple of studies done specifically to test what sperm levels in pre-ejaculate are like (and one done that inadvertently gave us some insight into what sperm levels might be even though they were intending to test for HIV transmission ability of pre-ejaculate).
The best one still has it’s limitations (small sample size, not knowing whether some of the pre-ejaculate may have been mixed with ejaculate, and the potential of the guys to not have gotten all their pre-ejaculate that they produced, among other things), but it still gives us a good idea of what’s happening:
- Viable sperm can still exist in pre-ejaculate (even when they have peed after the last time they ejaculated).
- Generally, total sperm count is low enough to not have a high likelihood of pregnancy occurring.
- It seems that some men have sperm in their pre-ejaculate and some don’t.
So you may know that’s it’s possible to use it and not have that bad of a failure rate, as long as you use it right. But what exactly is using it right?
How to use withdrawal correctly
Correct use of withdrawal entails a few things, and it’s important that if you are using withdrawal (especially if you want to use it during a time in your cycle that you KNOW you are fertile) you heed by each and every rule of the method.
So how do you use it correctly?
- Do not have intercourse right after previous ejaculation without the man peeing and washing (well) any area that may have come into contact with the ejaculate.
- Pull out BEFORE any amount of ejaculation happens. It’s better to be safe than sorry and if you/your partner has any doubts about their ability to do this correctly don’t use it.
- Ejaculate far away from the vulva. Don’t be like “I want to come on your bootie” and then have it dribbling down onto the vulva. Recipe for a mess up right there.
- Speaking of keeping the ejaculate away from the vulva, also don’t do anything like getting on your hands and then doing anything with the vulva/vagina with your fingers.
Situations it could be used to increase birth control efficacy
I’ve found that more often than not, women use withdrawal in conjunction with other methods.
Condoms+withdrawal (always using a condom and withdrawal)
Hormonal birth control+withdrawal (being on a hormonal birth control method and using withdrawal)
Fertility awareness+withdrawal (either using it during their infertile time to increase effectiveness or during their fertile time so they don’t need to use barriers or abstain).
Sometimes it’s done to increase the efficacy, sometimes it’s because other methods aren’t being used properly, and in the case of fertility awareness it could easily be done for either reason.
If you are using withdrawal while you are fertile and having unprotected intercourse in non-fertile times, you have less efficacy and even more reason to be very diligent with your withdrawal practices. While most people would say this is a totally inappropriate thing to do (use withdrawal while you know you are fertile? Gasp!), it’s obviously up to you as an individual what you want to use as birth control or as any combination. Fertility awareness and withdrawal can be used successfully together in this “less effective” way. I know because I’ve done it. So have others.
On the other hand, when you are using withdrawal to increase efficacy of fertility awareness you would be using withdrawal during all or some of your infertile time and abstaining or doubling up on birth control methods during your fertile time. In this case, your efficacy is going to be very very high.
Total efficacy of withdrawal alone
But what about just using withdrawal without any support of another method?
If you use withdrawal, and only withdrawal, perfectly your efficacy is going to be about 96%.
But if you only use withdrawal and you are not a perfect user your efficacy quickly drops down to about 73% (big difference, yeah?). That’s why it’s imperative if you decide to use it (and you care about keeping your chances of getting pregnant low) that you use it correctly, especially if you decide to pair it with fertility awareness in the “risky” way (aka, withdrawal during your fertile phase).
What do you think about withdrawal? How were you taught about it and how has that influenced your use of it?
Photo credit: Stuart Conner on flickr